Individual provider Active NPI

Kora Vanek, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Gladstone, OR
National Provider Identifier
1184432833
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1004118 Issued in OR
Practice address
890 82ND Dr BLDG B
Gladstone, OR 97027-1803
Phone
(503) 659-5515
NPI assigned
Dec 27, 2024
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 201142808RN OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1004118 OR Primary

Addresses

Primary practice location

890 82ND Dr BLDG B
Gladstone, OR 97027-1803

Mailing address

590 E Exeter St # a
Gladstone, OR 97027-1706
Phone (503) 754-8048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250424002858 OR Practitioner - Nurse Practitioner 4486170230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

890 SE
82ND
Gladstone, OR 97027-1803
Phone (503) 659-5515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
201142808RNORMDPsychiatric/Mental Health Registered Nurse
1004118ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC CurrentSince Apr 7, 2025 Accepting new patients
Western Psychological and Counseling Services LLC CurrentSince Apr 7, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

890 82nd Dr
Gladstone, OR 97027
Phone (503) 659-5515

890 82nd Dr
Bldg B
Gladstone, OR 97027
Phone (503) 659-5515

1750 Blankenship Rd
Ste 400
West Linn, OR 97068
Phone (503) 659-5515

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.koravanek@148835.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1184432833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 E EXETER ST # A",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271706",
            "telephone_number": "503-754-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 82ND DR BLDG B",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271803",
            "telephone_number": "503-659-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANEK",
        "first_name": "KORA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-27",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201142808RN",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "1004118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, OR

Sources for this page

Verify at the official NPI Registry.